Individual provider Active NPI

Luis Cardentey, M.D.

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1457640666
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME109256 Issued in FL
Practice address
13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone
(239) 936-1343
Fax
(239) 936-8507
NPI assigned
Mar 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X MD2008/0604 NM
Family Medicine Physician 207Q00000X ME109256 FL Primary

Addresses

Primary practice location

13813 Metro Pkwy
Fort Myers, FL 33912-4343

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other practice location 1

5220 Lee Blvd
Building 1
Lehigh Acres, FL 33971-1021
Phone (239) 344-2305

Other identifiers 1

IdentifierTypeStateIssuer
003728900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000598 FL Practitioner - Family Practice 5991604365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (239) 936-1343

Hospital & facility affiliations

  • Millennium Home Care LLC Home health agency, Port Charlotte, FL, CCN 109401
  • Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2008/0604NMMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Mar 11, 2019 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Mar 11, 2019 Accepting new patients

Locations

13813 Metro Pkwy
Fort Myers, FL 33912
Phone (239) 936-1343

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: luis.cardentey.1@4290.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1457640666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13813 METRO PKWY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124343",
            "telephone_number": "239-936-1343",
            "fax_number": "239-936-8507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5220 Lee Blvd",
            "address_2": "Building 1",
            "address_purpose": "LOCATION",
            "city": "Lehigh Acres",
            "state": "FL",
            "postal_code": "339711021",
            "country_code": "US",
            "telephone_number": "239-344-2305",
            "fax_number": "239-368-2044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDENTEY",
        "first_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NM",
            "license": "MD2008/0604",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME109256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003728900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.